Modifier 99

Modifier overflow

Instructions

When more than four modifiers are required to describe a service on the same code, replace the fourth modifier with modifier 99.

Correct Use

  • Replace fourth modifier with modifier 99 in Item 24D of CMS-1500 claim form or its electronic equivalent
  • Reflect only overflow modifiers in Item 19 of CMS-1500 claim form or its electronic equivalent
  • Documentation must explain all modifiers appended
  • Includes informational and pricing modifiers
  • Certain modifiers may affect payment

Incorrect Use

  • In this situation, do not append other modifiers in Item 24D of CMS-1500 claim form or its electronic equivalent

Resource

 

Last Updated Wed, 02 May 2018 12:16:38 +0000